Surgical treatment of ischemic mitral regurgitation by repair and replacement
The combination of mitral regurgitation and coronary artery disease presents a most significant challenge to the cardiac surgeon. Over the years this entity has the highest operative risk of any of the commonplace, acquired cardiac lesions treated surgically. Previous results from our clinic and others have documented relatively high operative mortality rates due to the urgency of the presentation, the extremely precarious myocardial function, severe triple-vessel coronary disease and prolonged operative insult, or a combination of all four of these factors [3,7, 8,10,14, 16, 18]. Superimposed on a scenario of congestive failure due to severe valvular regurgitation is an often compromised ventricle derived from factors normally related to mitral regurgitation. In addition, the lack of deliverance of appropriate blood supply to these areas may be further complicated by a previous myocardial infarction and scarring. Many reported series have indicated an operative risk of 12–20% using valve replacement alone.
KeywordsMitral Valve Valve Replacement Mitral Regurgitation Papillary Muscle Mitral Valve Replacement
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